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Scc.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd. 1. Type of data. The rights of individuai an whom the data is stored or to be stored shall be as set foRh in this section. <br /> SuUd.2. (nformation required to be given individual. An individuai asked to supply private or contidential dataconceming himselfshall be <br /> iiiformed of: (a)the purpose and intended use of the requested data within the collecting state agency,pol itical subdivision,or statewide system;(b) <br /> whether he may reFuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to suppiy <br /> private or contidantial data;and(d)the identiry oFother persons or entities authorized by state or federal law ro receive tlie data.This requirement shal I <br /> not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement of6cer. <br /> The commissioner of revenue may.place thc notice required under this subdivision in the individual income ta�or pr��erEy tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of <br /> stored data on individuttls,and�vhether it is classitied as public,private orconfidential. Upon his further request,an individual who is the subject of <br /> stored private or public data on individuals shall be sho�vn the data�vithout any charge to him and,if he desires,shall be infortned of the content and <br /> meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six <br /> months thereafter unless a dispute or action pursuant to this section is pending or additional data on the i�dividual has been collected or created. The <br /> responsible authoriry shall provide copies of the private or public data upon request by the individual subject ofthe data. The responsible authoriN <br /> may require tha requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with r�ny request made pursuant to this subdivision,or within tive days of <br /> the date of the request,e�ciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request <br /> within that time,he shall so inform the individual,and may have an additional five days within which ro comply with the request,eecluding Saturdays, <br /> Sundays and legal holidays. <br /> Su�d.4.Procedure when datu is not accurate or complete. An individual may contest the accuracy or completeness of public or private data <br /> concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.The <br /> responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of <br /> inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bel ieves the datl to be correct. Data in <br /> dispute shall be disclosed only if tlie individual's statement of disagreement is included with the disclosed data. <br /> The determination of H�e responsible authority may be appealed pursuant to the provisions of the administrative procedure act rellting to <br /> contested cases. <br /> DATA PRIVACY ADVISORY <br /> In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforn�you that your request <br /> for a pern�it or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine your qualification for the permit or license <br /> requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The information �nay be shared with other local, state or federal agencies to the extent necessary to <br /> process the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under Ivi.S. 13.04(available upon request)to review private data on yourself. <br /> 6. Your full name is required to process this application or permit. <br /> �Te-���-, � � (J .' �, �--- ��.-�- t�c�- <br /> First D4iddlc Lxst <br /> �?/ C¢.��SL <br /> Addr ss -7G�_ <br /> a� S s�� v�,-,� �� 9 `�a Y-a��9 <br /> Ci1v Statc 7.ip Phane <br /> I understand my rights as stated above. <br /> Sig :iturc <br /> Reset Form 32 <br />